Information Collection

Notice of Rescission

IC 193319 under ICR 201705-1545-024 · OMB 1545-2180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2180 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TD 9491.pdf TD 9491	IC Document
TD 9744.pdf TD 9744	IC Document

IC Title:

Notice of Rescission

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 54.9815-2712

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,533	733	800
Annual IC Time Burden (Hours)	20	-5	25
Annual IC Cost Burden (Dollars)	250	250	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
TD 9491	TD 9491.pdf	05/12/2017
TD 9744	TD 9744.pdf	05/12/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.